电针对T10水平脊髓全横断尿潴留大鼠逼尿肌及尿道外括约肌肌电活动的影响

关键词：脊髓损伤  尿潴留  电针  逼尿肌  尿道外括约肌  肌电活动

Keywords:spinal cord injury  urinary retention  electro-acupuncture  detrusor  external urethra sphincter  myoelectric activity

摘要：

      目的：观察电针对T10水平脊髓全横断尿潴留大鼠逼尿肌及尿道外括约肌肌电协调活动的影响，初步探讨电针治疗本病排尿障碍的效应机制。 方法：将SD雌性大鼠随机分为假手术组10只、模型组9只、电针组9只，制作T10水平脊髓全横断尿潴留大鼠模型。造模后，每日按压大鼠腹部协助排尿。电针组大鼠取“关元”、“三阴交”穴，采用连续波持续电刺激15min。每天治疗1次，连续治疗7d。疗程结束后检测各组大鼠的残余尿量，逼尿肌以及尿道外括约肌的储尿期（灌注期）、排尿期肌电活动。 结果：电针组的残余尿量为（2.79±0.59）ml，明显小于模型组的（5.18±0.61）ml，大于假手术组的（0.09±0.01）ml，差异有显著性意义（P＜0.01）。电针组逼尿肌在储尿期和排尿期肌电活动幅度分别为（0.567±0.028）mV和（0.763±0.021）mV，明显高于模型组的（0.372±0.027）mV和（0.458±0.023）mV，而假手术组在储尿期和排尿期肌电活动幅度最高，分别为（0.672±0.032）mV和（0.900±0.029）mV，组间比较差异均有显著性意义（P＜0.01）。电针组的尿道外括约肌在储尿期和排尿期肌电活动幅度分别为（0.902±0.016）mV和（0.342±0.022）mV，明显低于模型组的（1.198±0.026）mV和（0.668±0.020）mV，但高于假手术组的（0.811±0.017）mV和（0.178±0.010）mV，组间比较差异均有显著性意义（P＜0.01）。 结论：电针能改善T10水平脊髓全横断大鼠早期的膀胱逼尿肌低反射状态，减小排尿期尿道外括约肌异常收缩的肌电活动幅度，降低排尿时的阻力，使膀胱逼尿肌与尿道括约肌协调性得到改善，从而减少T10水平脊髓全横断大鼠的残余尿量。

Abstract:

      Abstract Objective: To observe the effects of electro-acupuncture(EA) on coordination of detrusor and external urethra sphincter of complete T10 level spinal cord transection rats, to study the mechanism of EA treating on urination disorder in this injury. Method: Female SD rats were randomized into sham-operation group(n=10), model group(n=9) and EA group (n=9). The rat model of complete T10 level spinal cord transection was established. After modeling press was applied on the rat's lower abdomen every day. EA with continuous wave was administered at “Guanyuan” (RN 4) and “Sanyinjiao” (SP 6) acupoints for 15min. The treatment was carried 1 time every day, and last for 7d. After treatment course was finished, residual urine volume was measured, and detrusor myoelectric activity (DMA) and external urethra sphincter myoelectric activity (EMA) during urinary storage period (perfusion period) and micturition period were detected. Result: Residual urine volume (RV) of EA group was (2.79±0.59) ml, significantly lower than that of model group with (5.18±0.61)ml, higher than that of sham-operation group with (0.09±0.01)ml, the difference was statistically significant (P<0.01). Detrusor myoelectric activity (DMA) of EA group during urinary storage period (perfusion period) and micturition period were (0.567±0.028)mV and (0.763±0.021)mV, significantly higher than that of model group with (0.372±0.027)mV and (0.458±0.023)mV, Detrusor myoelectric activity (DMA) of sham-operation group during urinary storage period (perfusion period) and micturition period were the highest among the three groups, with (0.672±0.032)mV and (0.900±0.029)mV respectively. Comparison of various indicators among three groups, the differences were statistically significant (P<0.01). External urethra sphincter myoelectric activity (EMA) of EA group during urinary storage period (perfusion period) and micturition period were (0.902±0.016) mV and (0.342±0.022)mV, significantly lower than that of model group with (1.198±0.026)mV and (0.668±0.020)mV, higher than that of sham-operation group with (0.811±0.017)mV and (0.178±0.010)mV. Comparison of various indicators among three groups, the differences were statistically significant (P<0.01). Conclusion: EA could improve the early bladder detrusor lower reflex state of complete T10 level spinal cord transection rats. At the same time, EA could reduce the myoelectric activity amplitude caused by external urethra sphincter abnormal contraction, and reduce the resistance during urination. That could improve coordination between bladder detrusor and external urethra sphincter, reduce the residual urine volume of complete T10 level spinal cord transection rats.